

PERSONAL INFORMATION
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Please fill out your information completely, if you are not with a company, leave the company information empty, otherwise fill out the company information to the best of your ability.
YOUR INFORMATION
Name: Lizzy Summers
Contact Number: 9380833
Event Role: Organiser
Company/Organization: Department of Cultural Affairs, LSGOV
COMPANY INFORMATION
(Leave blank if not applicable)
Name of company/organization:
Contact Person:
Contact Phone / Hotline:
Registered Address:
Please fill out your information completely, if you are not with a company, leave the company information empty, otherwise fill out the company information to the best of your ability.
YOUR INFORMATION
Name: Lizzy Summers
Contact Number: 9380833
Event Role: Organiser
Company/Organization: Department of Cultural Affairs, LSGOV
COMPANY INFORMATION
(Leave blank if not applicable)
Name of company/organization:
Contact Person:
Contact Phone / Hotline:
Registered Address:
EVENT DETAILS
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Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason. If you do not have a specific time, date or location decided then please estimate these answers to the best of your knowledge.
EVENT SPECIFICS
Event Name: World Cancer Day - Brave the Shave
Location of Event: ULSA - Sport Hall
Date of Event: 04/02/2022
Start Time: 20:00
Planned End Time: 22:00
The time and date of the event is:
(Mark one of the below options with an X)
Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason. If you do not have a specific time, date or location decided then please estimate these answers to the best of your knowledge.
EVENT SPECIFICS
Event Name: World Cancer Day - Brave the Shave
Location of Event: ULSA - Sport Hall
Date of Event: 04/02/2022
Start Time: 20:00
Planned End Time: 22:00
The time and date of the event is:
(Mark one of the below options with an X)
- [X] Confirmed and not subject to change.
- [ ] Unconfirmed and may be subject to change.
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I wish to formally invite anyone in your department to participate in an upcoming event of ours. This is entirely voluntary but it would help if you were to spread the word among your department. We are looking for people wishing to donate or have their hair shaved for charity. The money will be donated to Cancer research and the hair to wigs for cancer patients.
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ATTACHMENTS
I wish to formally invite anyone in your department to participate in an upcoming event of ours. This is entirely voluntary but it would help if you were to spread the word among your department. We are looking for people wishing to donate or have their hair shaved for charity. The money will be donated to Cancer research and the hair to wigs for cancer patients.
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REQUEST INFORMATION
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Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason.
REQUEST & DOCUMENTATION
What are you requesting?
Please tick as many as are appropriate. If requesting LSFD presence at the event, please indicate if you require a specific type of unit. If you are unsure, please leave blank.
Do you have a Special Event Permit issued by LSGOV?
A Special Event Permit is required for all events that take place on public property ((anything that is not held on a script-owned ingame property)). If you require one and have not yet applied, please do so via the LSGOV's online portal.
Dependent on the specifics of the event, official presence by a Law Enforcement Agency may be required a the event. If you require one and have not yet applied, please select a Law Enforcement Agency and file a request via their portal.
Date: 26/01/2022
Signature: Lizzy Summers
Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason.
REQUEST & DOCUMENTATION
What are you requesting?
Please tick as many as are appropriate. If requesting LSFD presence at the event, please indicate if you require a specific type of unit. If you are unsure, please leave blank.
- [ ] Event Approval / Fire Safety Certification.
- [ ] LSFD presence at the event. Specific Units Requested:
Do you have a Special Event Permit issued by LSGOV?
A Special Event Permit is required for all events that take place on public property ((anything that is not held on a script-owned ingame property)). If you require one and have not yet applied, please do so via the LSGOV's online portal.
- [X] Yes. Provided copy: Copy of the Event Permit
- [ ] No, but I have applied. Date of Application: DD/MMM/YYYY
- [ ] No.
Dependent on the specifics of the event, official presence by a Law Enforcement Agency may be required a the event. If you require one and have not yet applied, please select a Law Enforcement Agency and file a request via their portal.
- [ ] Yes. Provided email: Copy of the confirmation email
- [ ] No, but I have sent a request. Date of Request: DD/MMM/YYYY
- [X] No.
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<Feel free to leave this blank if none.>
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AGREEMENTS
I, the below signed, certify that the information given on this event request form is true and complete to the best of my knowledge. I also agree to comply with the Los Santos Fire Department, agree to all the event requirements and agree to terms as outlined above. I agree that if I fail to comply with the terms established above, I would be subject to a fine issued by the Los Santos Fire Department. I also agree to inform the Los Santos Fire Department of any cancellations or rescheduling and failing to do would mean I would be subject to a fine issued by the Los Santos Fire Department.<Feel free to leave this blank if none.>
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Date: 26/01/2022
Signature: Lizzy Summers

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